TY - JOUR
T1 - Alabama coronary artery bypass grafting cooperative project
T2 - Baseline data
AU - Holman, William L.
AU - Peterson, Eric D.
AU - Athanasuleas, Constantine L.
AU - Allman, Richard M.
AU - Sansom, Monique
AU - Kiefe, Caterina
AU - Sherrill, Robert G.
N1 - Funding Information:
A CABG quality improvement project submitted by the Alabama Quality Assurance Foundation, the Peer Review Organization for Alabama, was funded. The purpose of this report is to describe the methods developed for the Alabama Cooperative CABG Project, and present results for the initial round of data abstraction and analyses. These data will be used for comparison when evaluating the results of collective efforts to improve the quality of CABG operations in this state.
Funding Information:
The analyses upon which this publication is based were performed under contract number 500-96-P605, entitled “Operation of Utilization and Quality Peer Review Organization for the State of Alabama,” sponsored by the Health Care Financing Administration, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The author assumes full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Health Care Financing Administration, which has encouraged identification of quality improvement projects derived from analysis of patterns of care, and therefore, required no special funding on the part of this Contractor. Ideas and contributions to the author concerning experience in engaging with issues presented are welcomed.
PY - 1999/11
Y1 - 1999/11
N2 - Background. The Alabama Cooperative CABG Project is a statewide process-oriented analysis of coronary artery bypass grafting (CABG). The purpose of this report is to present the first information generated by this analysis, which will serve as a baseline for subsequent quality improvement projects. Methods. Medical records of Medicare beneficiaries from Alabama, a comparison state, and a national random sample who had isolated CABG between July 1, 1995, and June 30, 1996, were examined. Fifty-six demographic, procedural, and outcome variables were abstracted. Quality indicators identified by the Alabama Quality Assurance Foundation Study Group included: internal mammary artery use, prescription of aspirin at discharge, duration of postoperative intubation, use of intraaortic balloon pump, readmission to intensive care unit, hospital readmission within 30 days, return to the operating room for bleeding, and in- patient mortality. Benchmark performance rates for quality indicators reflecting care processes were calculated. Results. Alabama, the comparison state, and the national sample consisted of 4,092, 2,290, and 1,119 patients, respectively. The processes of care and outcome, including risk-adjusted mortality, for CABG across the state of Alabama are generally similar to other states and nationwide samples. However, there was considerable variation at the local hospital level in Alabama for each quality indicator. Conclusions. The data provide a 'snapshot' of practice patterns for CABG in Alabama. A specific quality indicator (duration of intubation) was identified as a focus for statewide improvement. Hospital-specific variations in quality indicators suggested opportunities for improvement in other indicators at a number of hospitals.
AB - Background. The Alabama Cooperative CABG Project is a statewide process-oriented analysis of coronary artery bypass grafting (CABG). The purpose of this report is to present the first information generated by this analysis, which will serve as a baseline for subsequent quality improvement projects. Methods. Medical records of Medicare beneficiaries from Alabama, a comparison state, and a national random sample who had isolated CABG between July 1, 1995, and June 30, 1996, were examined. Fifty-six demographic, procedural, and outcome variables were abstracted. Quality indicators identified by the Alabama Quality Assurance Foundation Study Group included: internal mammary artery use, prescription of aspirin at discharge, duration of postoperative intubation, use of intraaortic balloon pump, readmission to intensive care unit, hospital readmission within 30 days, return to the operating room for bleeding, and in- patient mortality. Benchmark performance rates for quality indicators reflecting care processes were calculated. Results. Alabama, the comparison state, and the national sample consisted of 4,092, 2,290, and 1,119 patients, respectively. The processes of care and outcome, including risk-adjusted mortality, for CABG across the state of Alabama are generally similar to other states and nationwide samples. However, there was considerable variation at the local hospital level in Alabama for each quality indicator. Conclusions. The data provide a 'snapshot' of practice patterns for CABG in Alabama. A specific quality indicator (duration of intubation) was identified as a focus for statewide improvement. Hospital-specific variations in quality indicators suggested opportunities for improvement in other indicators at a number of hospitals.
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U2 - 10.1016/S0003-4975(99)01000-0
DO - 10.1016/S0003-4975(99)01000-0
M3 - Article
C2 - 10585026
AN - SCOPUS:0032711758
SN - 0003-4975
VL - 68
SP - 1592
EP - 1598
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -